When does low blood pressure become an emergency. What are the symptoms of dangerously low blood pressure. How is hypotension diagnosed and treated. What causes sudden drops in blood pressure. Can low blood pressure be life-threatening.

Understanding Blood Pressure Basics

Blood pressure is a crucial indicator of cardiovascular health, measuring the force exerted by blood on artery walls as the heart pumps. It’s expressed as two numbers: systolic (pressure during heartbeats) and diastolic (pressure between beats). Normal blood pressure ranges from 90/60 mm Hg to 120/80 mm Hg.

Why is blood pressure important? It ensures proper circulation of oxygen, nutrients, and hormones throughout the body while facilitating waste removal. When blood pressure falls below 90/60 mm Hg, it’s considered low blood pressure or hypotension.

Types of Low Blood Pressure

• Orthostatic hypotension: Sudden drop when standing up quickly
• Postprandial hypotension: Drop after eating, common in older adults
• Neurally mediated hypotension: Affects young people after prolonged standing
• Severe hypotension: Sudden, significant drop due to various causes

Recognizing Low Blood Pressure Symptoms

Low blood pressure doesn’t always cause symptoms, but when it does, they can range from mild to severe. Recognizing these signs is crucial for timely intervention.

Mild Symptoms of Hypotension

• Dizziness or lightheadedness
• Blurred vision
• Fatigue or weakness
• Nausea
• Difficulty concentrating
• Rapid, shallow breathing

Severe Symptoms Indicating an Emergency

• Confusion or mental disorientation
• Cold, clammy, pale, or blue-tinged skin
• Weak or absent pulse
• Loss of consciousness
• Severe chest pain
• Seizures

Is fainting always a sign of dangerously low blood pressure? While fainting can be associated with hypotension, it’s not always indicative of an emergency. However, frequent fainting episodes should be evaluated by a healthcare professional.

Causes of Low Blood Pressure

Understanding the underlying causes of hypotension is essential for proper management and treatment. Various factors can contribute to low blood pressure:

1. Dehydration
2. Blood loss
3. Certain medications (e.g., diuretics, beta-blockers)
4. Heart problems (e.g., heart failure, arrhythmias)
5. Endocrine disorders (e.g., thyroid problems, adrenal insufficiency)
6. Severe infections or allergic reactions
7. Nutritional deficiencies (e.g., vitamin B12 or folic acid)
8. Pregnancy

Can stress cause a sudden drop in blood pressure? While stress typically raises blood pressure, in some cases, it can trigger a vasovagal response, leading to a temporary drop in blood pressure.

When Low Blood Pressure Becomes an Emergency

Low blood pressure becomes a medical emergency when it severely impairs organ function or leads to shock. This typically occurs when blood pressure drops suddenly and significantly, or when it remains chronically low without the body’s ability to compensate.

Signs of a Low Blood Pressure Emergency

• Severe chest pain or difficulty breathing
• Sudden, severe headache
• Seizures
• Profound confusion or loss of consciousness
• Signs of shock (cold, clammy skin, weak pulse, rapid breathing)

How quickly can low blood pressure become life-threatening? In cases of severe blood loss or anaphylaxis, blood pressure can drop to dangerous levels within minutes, requiring immediate medical attention.

Diagnosing Low Blood Pressure

Diagnosing hypotension involves more than just a single blood pressure reading. Healthcare providers consider various factors and may perform several tests to determine the underlying cause.

Diagnostic Methods

• Blood pressure measurements in different positions and times
• Blood tests to check for anemia, electrolyte imbalances, or hormonal issues
• Electrocardiogram (ECG) to assess heart rhythm
• Echocardiogram to evaluate heart structure and function
• Stress tests to observe blood pressure changes during exercise
• Tilt table test for orthostatic hypotension

How accurate are home blood pressure monitors? While home monitors can be helpful for tracking blood pressure trends, they may not be as accurate as professional equipment. It’s important to have your device calibrated and to follow proper measurement techniques.

Treatment Options for Low Blood Pressure

Treatment for hypotension depends on the underlying cause and severity of symptoms. In some cases, lifestyle changes may be sufficient, while others may require medication or medical intervention.

Lifestyle Modifications

• Increasing fluid and salt intake (under medical supervision)
• Wearing compression stockings
• Avoiding sudden position changes
• Eating smaller, more frequent meals
• Regular exercise to improve circulation

Medical Treatments

• Medications to increase blood volume or constrict blood vessels
• Adjusting or discontinuing medications that may be causing hypotension
• Treating underlying conditions (e.g., heart problems, endocrine disorders)
• In emergencies: intravenous fluids, blood transfusions, or vasopressor medications

Can low blood pressure be cured permanently? While some causes of hypotension can be resolved, others may require ongoing management. The goal is often to control symptoms and prevent complications rather than achieving a “cure.”

Preventing Low Blood Pressure Episodes

For individuals prone to hypotension, prevention plays a crucial role in managing the condition and avoiding emergencies. Implementing certain strategies can help maintain stable blood pressure levels.

Preventive Measures

• Stay hydrated, especially in hot weather or during exercise
• Rise slowly from lying or sitting positions
• Avoid standing for prolonged periods
• Eat a balanced diet rich in vitamins and minerals
• Limit alcohol consumption
• Manage stress through relaxation techniques
• Monitor blood pressure regularly if prescribed by a healthcare provider

How effective is increasing salt intake for preventing low blood pressure? While increasing salt intake can help raise blood pressure in some cases, it’s not suitable for everyone and should only be done under medical supervision.

Living with Chronic Low Blood Pressure

For individuals diagnosed with chronic hypotension, adapting to the condition is essential for maintaining quality of life and preventing emergencies. Understanding your triggers and working closely with healthcare providers can make a significant difference.

Coping Strategies

• Keep a symptom diary to identify patterns and triggers
• Educate family and friends about your condition and emergency procedures
• Wear a medical alert bracelet
• Plan activities around times when blood pressure is typically more stable
• Consider counseling or support groups to manage emotional aspects of the condition

Can people with chronic low blood pressure lead normal lives? Many individuals with chronic hypotension can lead full, active lives by managing their condition effectively and making necessary lifestyle adjustments.

Understanding low blood pressure and its potential to become an emergency is crucial for maintaining overall health. While a blood pressure reading of 86/46 mm Hg is considered low, it’s not always an immediate cause for alarm if you’re not experiencing severe symptoms. However, it’s essential to monitor your condition closely and seek medical attention if you experience signs of inadequate blood flow to vital organs.

Remember, what constitutes an emergency can vary from person to person. Some individuals may tolerate lower blood pressure without significant symptoms, while others may experience severe effects at higher readings. Always consult with a healthcare professional to determine what’s normal and safe for your individual circumstances.

By staying informed, recognizing symptoms, and taking appropriate preventive measures, you can effectively manage low blood pressure and reduce the risk of it developing into a medical emergency. Regular check-ups and open communication with your healthcare provider are key to maintaining optimal cardiovascular health and overall well-being.

When is Low Blood Pressure An Emergency?

A functional circulatory system is essential to your overall health and wellbeing.

More than 100,000 times a day, your heart pumps blood through a closed system of arteries, veins, and other blood vessels to the organs, tissues, and cells that make up your entire body.

Your blood picks up and distributes oxygen, nutrients, hormones, and other elements as it travels.

It also absorbs waste products and helps your body eliminate them. 

Blood pressure is a measurement that tells doctors how intensely your blood exerts force on the walls of your veins as your heart pumps blood through your circulatory system.

When you visit a healthcare provider, they record your blood pressure as two measurements: systolic blood pressure, the first number, and diastolic blood pressure, the second number. 

Systolic blood pressure is the amount of pressure in the arteries that your heart creates when it pumps and fills the arteries with blood.

Diastolic blood pressure is the amount of pressure in your veins when your heart is at rest.

Once doctors have both numbers, they can determine whether you have normal blood pressure, low blood pressure (hypotension), or high blood pressure (hypertension).

Blood pressure can change as you move through your day, but it can put you at risk for other serious health complications if it is chronically or excessively low or high.

Chronic low blood pressure can mean that your heart, lungs, brain, and other vital organs don’t receive enough blood to function correctly. 

If you have low blood pressure but don’t experience symptoms, your condition is not severe.

That said, for some people, low blood pressure can lead to feelings of dizziness, weakness, nausea, pale skin, vision changes, and other symptoms.

When someone experiences a sudden drop in blood pressure or has very low blood pressure, they may experience more severe symptoms like shock, low heart rate, shallow breathing, and clammy skin.  

In rare cases, low blood pressure can become a medical emergency.

If you are experiencing mental confusion, blue or pale skin, loss of consciousness, difficulty breathing, low pulse, or other severe symptoms, call 9-1-1 or go to your nearest emergency room for immediate medical attention. 

What is Low Blood Pressure (Hypotension)?

Blood pressure is the measurement that tells doctors about the force of blood in your circulatory system.

Your blood pressure reading is expressed as two numbers.

The first number, your systolic pressure, indicates how much pressure your heart creates when it beats, and your veins are full of blood.

The second number, your diastolic pressure, is the amount of pressure in your veins when your heart is at rest. 

Blood pressure can change throughout the day, depending on the person, physical activity, the stress they experience, and other factors. 

For most people, blood pressure levels remain within what doctors consider a “normal” range: 90/60 mm Hg and 120/80 mm Hg.

Anything higher than 120/80 mm Hg is elevated or high blood pressure (hypertension).

Anything lower than 90/60 mm Hg is low blood pressure (hypotension).

Four major types of low blood pressure are delineated based on the causes of low blood pressure, symptoms, and other factors. They include: 

• Orthostatic hypotension or postural hypotension: People with this condition experience a sudden drop in blood pressure when they stand up too quickly. It’s common in older adults but can affect younger people who have been sitting or squatting for a long time.

• Postprandial hypotension: People (mostly older adults) with this condition have a drop in blood pressure after they eat. It most commonly affects people with Parkinson’s disease and related disorders.

• Neurally mediated hypotension: Children and young adults experience this condition after standing for a long time. 

• Severe hypotension: People with this condition experience symptoms after a sudden and significant loss of blood, heart attack, infection, or allergic reaction.

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Symptoms

Some people with chronic low blood pressure readings do not experience any symptoms.

In those cases, the condition may not require any treatment.

For others, however, low blood pressure can lead to severe symptoms or indicate an underlying problem.

Milder symptoms of low blood pressure include:

• Back pain 
• Blurry vision
• Confusion or difficulty concentrating.
• Dizziness
• Drowsiness
• Faded vision
• Feeling faint or lightheaded
• Headache
• Rapid or jumpy heartbeats

When blood pressure gets very low, very fast, your heart, brain, and other organs may not get the blood they need to function correctly, and you can go into shock.

Patients that have gone into shock may experience: 

• Clammy, blue, cold skin
• Rapid, shallow breathing 
• Sluggishness, sleepiness, or confusion
• Weak pulse or rapid pulse

Shock is a medical emergency and, in severe cases, can be fatal.

If you or someone you know has low blood pressure and is experiencing symptoms of shock, call 9-1-1 or go to the nearest emergency room immediately.

Causes

Patients can have or develop low blood pressure for many reasons.

Some people have naturally lower blood pressure than others.

As long as they don’t experience symptoms, doctors consider them healthy.

Specific health issues can cause low blood pressure for some patients.

The most common causes include:

• Adrenal insufficiency
• Age-associated blood pressure regulation decline
• Alcoholism
• A history of heart attack, heart failure, arrhythmias, or other heart problems
• Diabetes
• Heat exhaustion or heat stroke
• Hypothyroidism
• Lack of fluids (dehydration) 
• Liver disease
• Low blood sugar
• Nerve damage 
• Nutritional deficiencies like a lack of iron (anemia), folic acid, and vitamin B12
• Parathyroid disease
• Parkinson’s disease
• Pregnancy
• Severe allergic reactions (anaphylaxis)
• Severe blood loss from traumatic injury or internal bleeding 
• Severe infections (septicemia)

Some prescription medications, over-the-counter treatment options, and street drugs can also put patients at greater risk of developing low blood pressure. For example:

• Alpha-blockers and other high blood pressure medications
• Beta-blockers and other heart medications
• Erectile dysfunction medications 
• High blood pressure medications 
• Narcotics
• Tricyclic antidepressants 

When Hypotension is an Emergency

For most people, hypotension, or low blood pressure, is a condition that patients can manage with lifestyle changes and medicine.

However, in extreme cases, a patient with low blood pressure may develop severe symptoms that require immediate medical attention.

Underlying Conditions

Sometimes, low blood pressure can indicate the presence of severe conditions that are dangerous or even life-threatening.

For example, patients experiencing a heart attack or heart failure can develop low blood pressure, as can people with severe infections.

A severe allergic reaction or anaphylactic shock is one of the causes of low blood pressure.

Those who experience a loss of significant blood volume due to traumatic injury, burn, or internal bleeding can also develop symptoms of low blood pressure as a result.

If you are experiencing chest pain, rapid or shallow breathing, loss of consciousness, or seeing a blue tinge on your skin, these could be signs that you need immediate medical attention.

Call 9-1-1 or go to your nearest emergency room.

Sudden drops

Even when it’s small, a sudden drop in blood pressure can be a serious health problem.

If blood pressure drops sharply, the brain doesn’t receive enough blood to function correctly.

Even a drop of 20 mm Hg within a few minutes can cause dizziness, lightheadedness, and other uncomfortable symptoms. 

Risks of low blood pressure 

Patients can experience dizziness, fainting, and falls, a dangerous complication for older adults.

In serious cases, severe drops in blood pressure can decrease the blood flow to the heart and brain so much that they damage the organ’s ability to function.

Severe hypotension has been linked to stroke, shock, and cardiovascular issues.

When to Go to the ER

Low blood pressure can be a serious, even life-threatening condition.

If you or someone you know is experiencing extreme symptoms, call 9-1-1 or go to your nearest emergency room for treatment right away. 

Emergency symptoms may include: 

• Cold, clammy, or sweaty skin 
• A bluish tint to the skin 
• Chest pain
• Rapid breathing 
• Shallow breathing 
• Vision changes 
• Confusion 
• Loss of consciousness

If you experience symptoms after taking medication or have been diagnosed with low blood pressure and are experiencing an increased frequency in even mild symptoms, call your doctor to discuss your condition and next steps.

How to Treat Hypotension

If you have low blood pressure that doesn’t cause symptoms or only occasionally causes mild lightheadedness, you may not need to treat your condition.

If you have more significant symptoms, your doctor might suggest several lifestyle and medication changes for you to use to regulate your blood pressure better and improve your overall health and wellbeing.

Lifestyle changes

There are a few changes you can make to reduce the signs and symptoms of low blood pressure. They include: 

• Eating more salt: Increasing dietary sodium may help raise your blood pressure and keep it more regulated. 

• Drinking water: Increasing your intake of fluids can increase the blood you have in your body and help raise your blood pressure.

• Avoiding alcoholic beverages: Alcohol lowers blood pressure and should be avoided by patients who struggle with symptoms. 

• Eating small meals: Enjoying smaller meals more frequently can help you avoid the extreme eating-associated changes in blood pressure that can occur with heavier meals.

• Wearing compression socks or elastic abdominal binders: Compression socks and abdominal binders are designed to maintain blood flow and reduce swelling, which can help address the root cause of postural hypotension.

• Move slowly: Changing posture positions quickly can lead to drops in blood pressure. Avoid sitting or standing up too suddenly.

Medication changes

If you have made lifestyle changes and still experience symptoms related to low blood pressure, talk to your doctor about medication changes you can make to regulate your circulatory system better. 

Medications that can help address low blood pressure include: 

• Fludrocortisone (Florinef)
• Midodrine (Orvaten)

If you have been prescribed a medication that puts you at risk for low blood pressure, or if you experience symptoms like lightheadedness or feeling faint after taking a medication, talk to your doctor about switching to a treatment option that you can better tolerate.

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When to See a Doctor

Low blood pressure can lead to health complications if left untreated.

If you suspect you have low blood pressure or are experiencing any symptoms that you think might be related to blood pressure, call your doctor to make an appointment.

If you or someone you know is experiencing severe symptoms, including difficulty breathing, chest pain, clammy or blue skin, loss of consciousness, or confusion, that may indicate a medical emergency.

Call 9-1-1 or go to your nearest emergency room immediately.

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Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

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Frequently Asked Questions

What is the lowest blood pressure can be before seeking emergency medical help?

People experience low blood pressure differently. Some have low blood pressure and don’t experience symptoms, while others are more debilitated. If you have low blood pressure and begin to experience symptoms like cold, clammy, blue skin, rapid or shallow breathing, heart palpitations or chest pain, confusion, or loss of consciousness, you may need medical attention. Seek emergency care immediately.

Can low blood pressure be treated at home?

Low blood pressure can be life-threatening if left untreated. You can make specific lifestyle changes to help regulate and raise your blood pressure, but you should only use them to augment your doctor’s recommended treatment plan, not replace it.

Which is more harmful: low or high blood pressure?

If it is too high or too low, blood pressure can cause health complications. Therefore, always aim for a blood pressure reading in the normal range, between 90/60 mm Hg and 120/80 mm Hg.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

• Low blood pressure: Also Known as Hypotension. (Date Unknown).
  https://www.nhlbi.nih.gov/health-topics/low-blood-pressure

• Low Blood Pressure. (2022). ​
  https://medlineplus.gov/ency/article/007278.htm

• Low Blood Pressure (Hypotension). (2021).
  https://www.uofmhealth.org/health-library/abg6277

• Understanding Blood Pressure Readings. (2022).
  https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings

• Blood Pressure: When Blood Pressure is Too Low. (2022).
  https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/low-blood-pressure-when-blood-pressure-is-too-low

• Amazing Heart Facts. (1997).
  https://www.pbs.org/wgbh/nova/heart/heartfacts.html

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Low blood pressure – Hypotension, how to increase blood pressure? – Health World

What is low blood pressure?

Normal blood pressure ranges from 90/60 to 120/80 mmHg. If the pressure readings are less than 90/60, the pressure is considered low. This condition is called hypotension.

Each person has his own normal (working) pressure, so hypotension is usually called pressure, which is 20% lower than the working one. Many (most often thin women) live with hypotension for years and feel great. Doctors believe that these people are lucky – they are less likely to suffer from cardiovascular diseases.

Symptoms of low blood pressure

• Headache in the temples, sometimes headache in the back of the head or in the forehead is the most common symptom of low blood pressure. This symptom is directly related to circulatory disorders of the cerebral vessels.
• Dizziness, both sudden and after a sudden change in body position, especially in the morning, are also characteristic symptoms of low blood pressure. Usually dizziness is accompanied by darkening of the eyes, noise in the head, sometimes even fainting. Therefore, people with low blood pressure are not recommended to get out of bed abruptly.
• Feeling of weakness, fatigue, inactivity. Such people get tired very quickly, this is especially acute at the end of the working day – attention and memory decrease, the person becomes absent-minded, irritable, and he has mood swings. It is very difficult for them to be in the same position for a long time, for example, standing in line or washing dishes.
• Hypotension is often accompanied by vegetative disorders – sweating of the palms and feet, violations of thermoregulation – a decrease in temperature to 35.8 – 36 C, sometimes there may be a feeling of incomplete inspiration or shortness of breath during physical exertion.

What to do with low pressure?

If your blood pressure is consistently low but you feel good, there is no need to do anything. If you are concerned about nausea, dizziness or fainting, you need to consult a general practitioner in St. Petersburg.
The frequent occurrence of low blood pressure symptoms may indicate the presence of various diseases. In order to identify the cause, doctors conduct various examinations: ultrasound of the heart, blood vessels, ECG, FGDS. The therapist can refer to narrow specialists: a cardiac surgeon, a gastroenterologist, an endocrinologist, a neurologist. It is important to find out the true cause, because the method of treatment depends on the diagnosis.

General recommendations for hypotension:

• Drink plenty of fluids and salt. In summer, a person quickly loses water and minerals.
• Drink coffee, tea or cocoa. Drinks with caffeine give a good effect, though short-term.
• Avoid stuffiness, extreme stress or fright.
• Maintain a good mood.
• Perform simple exercises that are useful for hypotension: sit in a cross-legged position, clench and unclench your fists, work with a manual expander.

What to do if there is a sudden drop in pressure?

First, you need to take a supine position. If there is no way to lie down, you must definitely sit down and tilt your head as low as possible, between your knees. This position will ensure the flow of the required amount of blood to the brain and well-being will immediately improve.

Secondly, you should immediately drink a glass of water or, best of all, strong sweet tea. When fainting, you can revive him with a bottle of essential oils or ammonia. It is necessary to bring the bottle to the nose and lightly smear the whiskey. These measures will help in the shortest possible time to normalize blood pressure and bring a person back to normal.

Consequences of low blood pressure

• In children and adolescents, hypotension often occurs due to rapid growth, a malfunction occurs in the autonomic nervous system. As a result, when you change your posture or bend over, you get dizzy, fainting, which leads to injuries and accidents. In this case, physical activity is recommended – running, swimming, walking is better. Children usually outgrow the problem and hypotension goes away on its own.
• Hypotension in adulthood, especially in atherosclerosis, can cause ischemic stroke. In addition, with hypotension, angina pectoris and atherocardiosclerosis rapidly progress.
• Low blood pressure during pregnancy can even cause loss of the baby. Such expectant mothers should follow the doctor’s recommendations: walk more in the fresh air, have good sleep and nutrition.

Last update: 06/17/2021

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Cardiologist told when low blood pressure is life-threatening0003

A cardiologist told when low blood pressure is life-threatening – RIA Novosti, 06/02/2021

A cardiologist told when low blood pressure is life-threatening – cardiologist Natalya Gavrilyuk. RIA Novosti, 06/02/2021

2021-06-02T08:56

2021-06-02T08:56

2021-06-02T11:18

society

Alexander Myasnikov (doctor)

pressure

health – society

/html/head/meta[@name=’og:title’]/@content

/html/head/meta[@name=’og:description’]/@content MO SKVA, June 2 – RIA Novosti. A sharp drop in blood pressure should be alarming if it happened for the first time, cardiologist Natalya Gavrilyuk said in an interview with Channel Five. According to the physician, conditionally dangerous pressure is 90/60 millimeters of mercury. For some people, such indicators are normal due to the characteristics of the autonomic nervous system. In particular, this applies to young thin girls. However, if blood pressure has dropped sharply for the first time, you should go to the hospital as soon as possible. “Also combined with cold sweat, chest pain, shortness of breath and tachycardia, maybe even loss of consciousness,” the cardiologist explained. life-threatening arrhythmias and stroke. Gavrilyuk noted that an overdose of drugs to reduce pressure also requires urgent hospitalization. This applies to those cases when a person suffering from hypertension, after a large number of drugs, uncharacteristic hypotension is observed. Such a condition can lead to death."Medicated hypotension is quite dangerous <…> Therefore, if a decrease in blood pressure is associated with an excess of antihypertensive drugs, in this case we can also talk about emergency hospitalization, ”summed up the physician. Previously, doctor and TV presenter Alexander Myasnikov warned against measuring blood pressure too often. For one-time jumps, he advised using Holter monitoring to find out the average pressure.

https://ria.ru/20210309/napitok-1600453928.html

https://ria.ru/20210216/muzyka-1597586492.html

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society, Alexander Myasnikov (doctor), pressure, health – society

Society, Alexander Myasnikov (doctor), Pressure, Health – Society

MOSCOW, June 2 – RIA Novosti. A sharp drop in blood pressure should be alarming if it happened for the first time, cardiologist Natalya Gavrilyuk said in an interview with Channel Five.

According to the doctor, 90/60 millimeters of mercury is considered to be a conditionally dangerous pressure. For some people, such indicators are normal due to the characteristics of the autonomic nervous system. In particular, this applies to young thin girls.

However, if your blood pressure drops for the first time, you should go to the hospital as soon as possible.

“Also combined with cold sweat, chest pains, shortness of breath and tachycardia, maybe even loss of consciousness,” the cardiologist explained.

Named a drink that lowers blood pressure

March 9, 2021, 13:37

Medical assistance is needed to rule out acute conditions: the doctor attributed them to heart attack, pulmonary embolism, life-threatening arrhythmias and stroke.

Gavrilyuk noted that an overdose of drugs to reduce pressure also requires urgent hospitalization. This applies to those cases when a person suffering from hypertension, after a large number of drugs, uncharacteristic hypotension is observed.